Sex reassignment surgery, also known as gender confirmation surgery, refers to a group of surgical procedures that help alter a person's physical appearance and function in order to more closely align with their gender identity. It is usually the last stage in treatment for severe gender dysphoria in transgender individuals.

Types of Surgeries

There are a few main types of surgeries that fall under sex reassignment surgery:

Top Surgery
Top surgery refers to surgical procedures that alter the chest/breast area. For transgender men, this would involve breast removal or a mastectomy. For transgender women, this may involve breast augmentation.

Bottom Surgery
Bottom surgery refers to surgical procedures that alter genital features. Some common bottom surgeries for transgender women include penile inversion vaginoplasty and colon vaginoplasty. Penile inversion vaginoplasty constructs a neovagina from the penile skin. Colon vaginoplasty uses a segment of the colon to construct the neovagina.

For transgender men, common bottom surgeries include metoidioplasty or phalloplasty. Metoidioplasty encourages existing genital tissue from the clitoris to grow in size and function similarly to a small penis. Phalloplasty uses skin grafts or tissue from other body parts to construct a phallus.

Facial Feminization/Masculinization Surgery
Some transgender individuals opt for facial feminization or masculinization surgery to alter facial features like the brow, brow bone, hairline, fat deposits, Adam's apple size, and more to be closer to their gender identity.

Eligibility and Preparation
To be eligible for sex reassignment surgery, one must typically undergo hormone therapy for at least one year and obtain letters from two mental health professionals confirming they are of sound mind and fully understand what these surgeries entail.

Extensive physical and psychological evaluations help determine readiness. Close follow ups with physicians are important before and after surgery too for safety and support with recovery and adjustment. Lifestyle changes like quitting smoking several weeks prior to surgery help optimize healing.

Risks and Complications
While these surgeries have high patient satisfaction rates when performed by experienced surgeons, they carry risks like infection, changes in sensation or function, poor cosmetic outcomes, wound healing issues, etc. Post-surgery hormone therapy, dilators, or implants may be needed too.

The psychological risks of regret or dissatisfaction are also possible, so candidates must be firmly committed to transition. Counseling and living as their affirmed gender for over a year beforehand helps ensure decisions are well-considered.

Cost and Insurance Coverage

Sex reassignment surgery is a complex set of procedures that can range from $20,000-$100,000 or more depending on the surgeon, type of surgery and location. However, costs are steadily declining as knowledge and techniques improve.

Insurance coverage varies tremendously across countries and regions. In some US states and countries like Canada, sex reassignment surgery may be covered if the patient meets diagnosis criteria and goes through therapy. However, exclusion from health plans remains common in other areas. Out-of-pocket payment plans are an option.

Public Acceptance Growing

Attitudes towards transgender people are slowly becoming more progressive and understanding worldwide. However, stigma, discrimination and lack of access to care persist unfortunately - especially outside major metropolitan areas.

Visibility through advocacy, education and media representation has helped push for legal protections and social normalization of transition-related healthcare as essential medical need over the past decade. Still, trans individuals face high rates of violence, harassment, family rejection, unemployment and other challenges sadly.

Ongoing Progress in Care

Sex reassignment surgery continues evolving to offer improved function, sensation and appearance outcomes. Minimally invasive techniques, 3D modeling, stem cells and other advances may someday allow tailoring procedures precisely for each patient's anatomy and desires. Post-operative care accessibility also needs strengthening in underserved communities.

With supportive healthcare, trans people can finally see, feel and present as their authentic selves internally and externally through these treatments. The profound human impacts of such affirming medical care deserve respect worldwide.